DESCRIPTION: (paraphrased or quoted from proposal) Survival is only one goal of cardiac transplantation. Recipients' and their families' long- term psychological adaptation must be considered when evaluating costs and benefits of this therapy. Beyond investigations of health in the short-term (i.e. the first year) post-transplant, little data are available on the occurrence or course of clinically significant levels of psychiatric disorder among recipients in the longer-term years post- transplant during which important medical complications are likely to emerge. There are no systematic data on whether long-term stresses emanating from recipients' post-transplant status affect the mental health of their primary family caregiver. Despite assertions that both parties' mental health are critical predictors of recipients' medical compliance and hence of their physical health and long-term survival, empirical evidence regarding such relationships is lacking. This group is currently assembling a cohort of heart recipients (N=142, 125, 155 at Years 2,3,4 respectively), assessed with detailed psychiatric, medical compliance, and psychosocial evaluations on repeated occasions. Hypotheses are articulated on the interrelationships of post-transplant mental health, compliance, psychosocial factors of both recipient and caregiver, physical health.